Stories are at the heart of direct service and clinical work. Whether written in case notes, shared in supervision, included in grant reports, or told at community meetings, stories help others understand the impact of our work. They build emotional connection in ways data alone cannot. But storytelling is also an act of power, and when we’re not careful, that power can unintentionally cause harm.
For many families, their stories are told about them, not with them. Direct service providers often hold the microphone through professional language, reports, and presentations. Even with good intentions, stories can strip dignity, reinforce stereotypes, or expose families to stigma, especially in small or close-knit communities where anonymized details are often still identifying.
Dignified storytelling asks us to slow down and be intentional. At its core is a simple truth: it’s not our story. The direct service provider’s role is not to extract compelling narratives for program promotion, but to honor people’s humanity, safety, and agency while still communicating the value of direct service work.
One of the most common pitfalls is what some call “hardship” or “bootstrap” storytelling. This is the idea that success comes only from individual effort and that suffering must be emphasized to prove impact. These stories often rely on pity-inducing language, exaggerate trauma, or cast providers as heroes while families appear passive or broken. Not only does this framing erase strengths and resilience, it ignores the real systems that shape people’s lives, such as access to housing, healthcare, childcare, and economic opportunity.
A more ethical approach focuses on balanced, multidimensional stories. Dignified storytelling acknowledges challenges while also highlighting strengths, goals, decision-making, and progress. It shows people as parents, workers, community members, and partners and not just as clients or problems to be solved. It shifts the narrative from rescue to relationship.
Consent is another critical piece of ethical and dignified storytelling. Consent is not just a form signed once and filed away. True informed consent requires that people understand why their story is being shared, what will be created, where and how it will be shared, and for how long. It must happen in accessible language, in settings where it’s genuinely safe to say no, and with the clear understanding that consent can be withdrawn at any time. What felt acceptable at intake may not feel safe months or years later.
Sometimes, the most ethical storytelling choice is not to share a story at all. If there is any risk of harm, retraumatization, stigma, or identification, especially in situations involving young children or families facing substance use, violence, or child welfare involvement. The answer may need to be no. Saying no to sharing a client’s story isn’t a failure; it’s ethical leadership.
Fortunately, there are always alternatives. Aggregated data, composite stories, systems-level insights, and reflective narratives can demonstrate impact without putting individuals at risk. And when individual stories are shared. Co-creation, with families reviewing and approving how they’re represented, offers one of the strongest safeguards.
A useful litmus test is this: If you wouldn’t want the family to read what you wrote about them in an article or report, don’t write it. People are always more important than program promotion.
Every story is an opportunity to honor or to harm. The choices that clinicians and other direct service providers make every day shape not only individual experiences, but organizational culture and public understanding. Practicing dignified storytelling helps ensure that the stories we tell today build trust, respect, and dignity for years to come.
Richard P. Holm, MD passed away in March 2020 after a battle with pancreatic cancer. He is founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® ® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook. Darla Biel, Ed.D. is Assistant Director of the Center for Prevention of Child Maltreatment (CPCM) within USD’s School of Health Sciences.
